Hormonal influences on brain ageing quality: focus on corticotropin releasing hormone-, vasopressin- and oxytocin-immunoreactive neurones in the human brain.

In this paper we have investigated the distribution of corticotropin releasing hormone (CRH)-, vasopressin- and oxytocin-immunoreactive (IR) neurones in the paraventricular nucleus in the senile compared to the adult human brain. We found a higher number of CRH-IR neurones in senile compared to adult subjects. Vasopressin- and oxytocin-IR neurones were instead more weakly stained in the former compared to latter. These results support a hypothalamic involvement in promoting the higher activity of the hypothalamus-pituitary-adrenal axis and, thus, higher glucocorticoid plasma levels which have been described in the elderly.

Hodgkin's disease presenting in 1 of 4 siblings affected by hereditary spinocerebellar ataxia: clinical, immunological and genetic study.

One of 4 siblings affected by hereditary spinocerebellar ataxia (HSCA) of Marie's type developed Hodgkin's disease (HD): the stage was IV B, the patient was submitted to conventional chemo- and radiotherapy and achieved complete remission. An accurate clinical, genetic and immunological study was carried out on all his family, including a complete HLA typing, a chromosome study, the immunophenotyping of peripheral blood mononuclear cells (PBMC), the PBMC response to polyclonal mitogens, to interleukin 2 (IL-2), to the association of PHA + IL-2 and the evaluation of the IL-2 receptor expression. No association was clearly demonstrable between an HLA haplotype and HSCA, while the patient with HSCA and HD was HLA-B18- and DQw3-positive (the last at homozygous level), two antigens known to be strongly associated with HD, mainly among the Sardinian ethnic group. The mode of inheritance of HD susceptibility is however completely different from that of Marie's HSCA. The chromosome study did not show any characteristic pattern of the karyotype, neither of the HSCA affected nor of the unaffected members. The immunological investigations did not elucidate any characteristic behavior of the family members, apart from the typical findings of HD seen on patients with HSCA and HD. Our study could not demonstrate any genetic and/or immunologic common background shared by the two diseases, HSCA and HD. Their coexistence in our patient, although the statistic probability is very low, seems to be a fortuitous coincidence more than the result of a common genetic and pathogenetic mechanism.

[Hydatid localization in the proximal tract of the right branch of the pulmonary artery. Description of a case]. / Localizzazione idatidea nel tratto prossimale del ramo destro dell'arteria polmonare. Descrizione di un caso.

Hydatid localization in the major branches of the pulmonary circulation have rarely been reported. The AA. describe the case of a young male patient, previously operated for pulmonary and hepatic hydatidosis, who was unresponsive to medical treatment and died of right heart failure. At necropsy a large hydatid cyst occluding the right proximal branch of the artery was found.

Patent muscular vessels in atheromatous obstruction of tibial arteries: a support of more peripheral revascularization procedures?

A considerable number of patients having aorto-femoral surgery for chronic obliterative atherosclerosis show evidence of obstructed run-off vessels. In this condition poorer long-term results were documented in many series. The present study was aimed at investigating the state of 33 small muscular arteries of 8 limbs amputated for atherosclerotic gangrene. Histological studies showed that 11 muscular arteries were completely free from atheromatous lesions and that another 11 with minor abnormal features could be considered susceptible of revascularization. The conclusive data from this study in a small series suggest that in generalized atherosclerotic obstruction of lower limbs, nearly 70 per cent of the muscular vessels distal to the obstruction are potentially suitable for revascularization.

Familial chronic B-cell malignancy. Hairy cell leukaemia in mother and daughter.

Two familial cases of hairy cell leukaemia are reported: a daughter, 44-years-old, with a very unusual ultrastructural pattern found in hairy cells, the "tubuloreticular inclusions", and her mother, 71-years-old, who was affected six years later. Routine laboratory investigations, cytochemical and cytogenetic studies including HLA typing, as well as in vitro proliferative response of peripheral blood mononuclear cells (PBMC) to polyclonal mitogens and to exogenous interleukin 2, were performed. The immunological characterization by assessing the cell surface phenotypic markers with monoclonal antibodies and transmission electron microscopy (TEM) investigations were also carried out. In case 2 all tests were performed both on PBMC and on the bone marrow cells. To the best of our knowledge this is one of the first reports of such familial association. The possibility that genetic factors might play a role in the etiology of leukaemia in man is discussed: in our two cases, however, cytogenetic studies did not support this, while HLA typing revealed a non-significant association of HCL with DQw3 allele. Alternatively, an environmental factor has been considered, and a viral infection-perhaps by a retrovirus of the HTLV family has been suggested as tubuloreticular inclusions have been found in both hairy cell leukaemia, as reported, by us, and AIDS-LAS. However, a long time elapsed between the manifestation of HCL in the daughter and in the mother, and as the two patients had not been living together at that time, the possibility of a viral transmission seems minimal. The results of TEM and of immunological investigations are presented and discussed. Both, but particularly the latter, support the B cell nature of the hairy cell.

Hypothalamus-pituitary-adrenal axis of heroin addicts.

The hypothalamus-pituitary-adrenal axis of heroin addicts was investigated by evaluating plasma cortisol levels throughout the day in 37 heroin abusers (HA), 17 of whom showed detectable morphine levels, indicating heroin administration in the previous hours and in 12 controls. All HA showed lower cortisol levels in basal condition (100.7 +/- 61.7 ng/ml, M +/- S.D.) compared to the control group (159.7 +/- 40.6, P less than 0.05). Moreover all HA (65.1 +/- 28.9%), and in particular those taking heroin during the study (39.1 +/- 41.4%), show a reduced cortisol decrease in the evening, which was significantly lower than in controls (85.3 +/- 10.1%; P less than 0.01). As far as the acute effects of opiates are concerned morphine (0.1 mg/kg) significantly reduced plasma cortisol levels within 60 min in a group of 8 healthy subjects. The same pattern was displayed by only 3/8 HA whose morphine levels were higher than 1 ng/ml, i.e. in those reaching the highest plasma morphine concentrations. These data indicate that chronic opiate abuse leads to a hypoadrenalism which could be the result of morphine-induced changes at the hypothalamic level.